GENERAL DESCRIPTION OF POSITION:
Reports directly to assigned Workflow Manager. The Primary duty of the Workflow Monitor is to monitor real-time or prior day schedules for services due and billing alignment; provide support/corrective efforts for areas demonstrating consistent missteps (3 to 7 days of unaddressed/un-coded measures, bypassed alerts, etc.) This position ultimately bridges gaps between scheduling and pre-visit planning, correct insurance connections, and service quality (evidenced by coding submitted).
DETAILED DESCRIPTION OF POSITION:
- Using the Relevant Platform, ID patient outreach lists by high volume Providers , then by specific disease/measure groups
- Compare Pre and Post-visit planning items due (Superbill – click it in the Navigation pane when in Nextgen)
- Communicate with Providers Providers real-time, when gaps are identified on the same day.
- Randomly sample and engage patients about their experience to determine service needs to share with the Provider team.
- When Providers have areas of consistent incongruence (3 to 7 days of unaddressed/un-coded measures, bypassed alerts), obtain Coder training intervention through the Accountable Care Organization.
- Assists Nursing team in tracking patient visits and health outcomes.
- Prepares status reports (weekly, monthly, quarterly)
- Required to document as need in the EHR.
- Support Accountable Care Organization (ACO) requests
- Other related duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
- Excellent oral and written communication skills.
- Ability to maintain confidentiality of information to include protected Health Information.
- Ability to work as a member of a team and promote teamwork with other staff Members.
- Ability to work with clients in a compassionate, non-judgmental manner.
- Ability to work and act independently.
- Knowledge of computers and multiple programs.
- Ability to manage multiple projects.
MINIMUM QUALIFICATIONS:
Must have High School Diploma . Healthcare experience preferred. Basic knowledge of computer applications is essential. Carries out independent field work, maintain records, and participate in cooperative efforts with numerous agencies and programs. Bilingual a plus.
TYPICAL PHYSICAL DEMANDS:
Requires some standing/walking/sitting. Requires travel from one site to another. Use of telephone required.
TYPICAL WORKING CONDITIONS:
Eight (8) hour workday. Some contact with patients and staff.